NPI | 1124624143 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020039457) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-159764) |
Enumeration Date | 2020-12-06 |
Last Update Date | 2021-09-28 |